I keep getting a really sore vagina, it's really red all round the outside,
plus it's very sore and itchy . I've seen my GP on numerous occasions and tried
loads of creams , it takes ages to go then keeps coming back !
Dr doesn't know what it is or seems to care .
Does anyone else get this ? It's so painful to sit .

Get GP to do swab for thrush. You don’t have to have a cottage cheese discharge or itch to have it

Hormones and vaginal atrophy. If you are peri, menopausal or post menopausal you need oestrogen to keep things happy down below. I’d ask for a referral to a uro gynae to manage these symptoms.

For the time being use a gentle barrier cream or wash such as Hydromol or Yes or Sylk lubricants. All entirely natural with no additives.

Many women will begin to suffer with infections when they become peri-menopausal (from around the age of 35 onwards), menopausal or have premature menopause. This can cause vaginal dryness and vaginal atrophy due to the thinning of the vaginal mucosal lining as a result of declining oestrogen levels. This urogenital thinning also affects the mucosal wall of the bladder allowing bacterial permeability. The walls of the vagina, urethra and bladder rely on oestrogen as one way to stay toned and able to manage the flow of urine from the bladder. With less oestrogen these organs lose tone and some degree of function.

Additionally, oestrogen (or estrogen) is needed for the vagina to maintain its natural flora and lubrication. The PH of the vagina is usually acidic but during these changes or when using oral contraception or IUD contraception, it can become alkaline leading to a rise in bacterial anaerobes, candida or bacterial vaginosis. The vaginal PH also changes shortly before and during menstruation and this is often when pre-menopausal women experience increased candida symptoms and anaerobe growth. Usage of tampons can cause prolonged vaginal PH issues during menses as the body is unable to naturally expel the menstrual blood which is itself alkaline.

Hi Susan, I have had a swap test for thrush which came back positive but
The cream prescribed isn't helping . I have a red rash on the outside all
around my vagina .
I am post menopausal but cannot take HRT . I've tried Hydromol which doesn't help.
Will ask GP for Yes or Sylk.

Ok in which case the following may help for Thrush. Yes or Sylk can be purchased online or from a chemist. Its unlikely that a GP would have these as prescription treatments.

Topical treatments

Within the Multi- Gyn product range there is Multi-Gyn active gel (formerly known as Bio-fem active gel) for Bacterial Vaginosis and there is Multi-Gyn Floraplus for thrush. Both of these gels can be purchased over the counter from pharmacies or online.

Clotrimazole or Canesten cream. Canesten is the branded product and also contains more of the active ingredient at 2%, but is more expensive. Clotrimazole only contains 1%. If you have vulval vaginal issues please check if any additives may cause irritation before usage. These can be purchased at any pharmacy.

There are also intravaginal pessaries such as clotrimazole or canesten pessaries, econazole and miconazole. These work in a similar way to the cream, but can cause burning, vaginal dryness and further irritation to some, again use with caution if you are very sensitive.

Salcura Topida thrush spray: This can be used for thrush, Bacterial Vaginosis and for general discomfort caused by the bacteria from the urine coming into contact with the vulva. It is a product that uses natural ingredients – including lavender oil, tea tree, garlic oil and Manuka oil. It doesn’t have any of the harsh additives or preservatives of some of the standard over the counter products and may be suitable if you are sensitive. Some women have reported it gives instant relief.

The probiotic VSL3 can also be mixed with a small amount of water, just enough to make a paste and inserted in the vagina which can help to relieve and treat thrush.

Boric Acid Pessaries: Boric acid is a white, crystalline chemical substance that has antifungal and antiviral properties. It is used in various prescription pharmaceutical products and is also available without a prescription in some countries. Vaginal boric acid capsules are a treatment option for vaginal yeast infections, particularly infections that can’t be cured by antifungal yeast infection medicines. If you are pregnant, do not use vaginal boric acid treatment.

When used in capsules as a vaginal suppository, boric acid is known to sometimes cause skin irritation so again if vaginal or vulval tissues are sensitive please discuss with either a pharmacist or appropriate practitioner before purchasing for treatment. When used by mouth (internally) or on open wounds boric acid is toxic. Keep boric acid out of the reach of children.

How to apply topical medications: Thrush spores congregate around the clitoral hood and the anus so apply a pea sized dose to both areas twice daily as well as those areas where the itching is most intense. Ensure that the anal application is the last area applied to prevent any bacteria being transferred to the vulva and around the urethral entrance.

Oral Medications

Fluconazole or Canesten oral. These are the same, but Canesten is the branded name. They can both be purchased over the counter in any pharmacy. They are taken either in a one off oral dose or longer under the guidance of a GP or physician.

Prescription Oral medication

Fluconazole or the stronger Itraconazole can be prescribed by a doctor for a longer period and always discuss recommended dosage and length of usage with your practitioner.

With high-dose oral fungal medications, it is recommended that liver function is checked regularly via a GP blood test.

Nystatin Powder: Another alternative treatment is to take Nystatin powder, this is usually prescribed by an environmental doctor and can be taken orally and vaginally if suffering systemic candida issues alongside vaginal candidasis.

If you are in treatment with a natural practitioner discuss dosage with them or contact the manufacturer. Do not take if you are pregnant or breastfeeding. Please note that GSE is a powerful antimicrobial with similar effects to those of antibiotics and will need to be taken alongside a probiotic under the guidance of an appropriate Naturopath or alternative health care provider.

Uva Ursi

Again a powerful antimicrobial and this should not be taken no more than 5 times a year. Probiotics should also be taken during and after treatment and guidance should be provided by a naturopath or alternative health care provider.

Garlic capsules/powder such as Allicin Max

Diet: In order to prevent thrush it is important that you limit your sugar, refined carbohydrate and yeast intake. Caution is also needed when eating fruit as the yeast will feed on the fruit sugar. At this time of the year there are way too many sugary and carbohydrate treats so you have to be disciplined about this if you want to clear the thrush.

There are plenty of examples of Candida diets available but the above principles are a good starting point. An appropriately qualified practitioner can provide guidance for someone starting an anti-candida diet so that whole body health can be managed and monitored as candida die-off can cause unpleasant symptoms.

What are probiotics, and what role do they play in the body?

Inside the digestive tract, there are around 100 trillion bacteria that live in the intestines.

Probiotics are a culture of “good” bacteria. When the word probiotic is used, it is to talk about a supplement (a pill or powder) of beneficial bacteria, but it can also be used when talking about fermented foods such as Kefir.

How can the gut flora be disrupted?

There are a number of things that can disrupt the balance of gut bacteria and cause dysbiosis:

Probiotics are bacteria and can be supplemented in tablet or powder form. Additionally, food-based sources of probiotics include anything fermented and not pasteurized, as pasteurization will kill the bacteria. These foods include sauerkraut, kimchi, lacto-fermented fruits and vegetables, non-pasteurized yogurt, kefir and cheese, non-pasteurized meats like salami and some sausages. However please note if you have issues with histamine, it is advised to be careful when supplementing with probiotic foods as the fermentation process can increase histamine release.

Any given probiotic supplement has a either a single or different mix of different strains of healthy probiotic bacteria, each of them are equally important and, all of them must occur in a delicate, proportional balancing act. Regardless of claims, no one brand has the entire mix exactly as it occurs intestinally. Thus, it is generally recommended to rotate a variety of different brands, to better cover the entire spectrum, or come as close as possible. Other key points to remember are:

Ideally, look for a potency count (CFUs or “colony forming units”) of 50 billion or higher. That’s how many bacteria you will receive per dose.
What’s the shelf life of the CFUs? You don’t want just the CFUs at “time of manufacture.” You also need to know how long the CFUs will retain their viability.
Look for valuable strains, including species of Lactobacillus and Bifidobacteria such as:
Lactobacillus acidophilus and Lactobacillus plantarum that reside in the small intestine or the upper gastro intestinal tract among your immune cells.Bifidobacterium lactis, Bifidobacterium longum, and Bifidobacterium bifidum that reside in the large intestine or the lower bowel, which are also critical areas for health.

Probiotics need to be taken at least 2 hours before or after antibiotics and/or other natural anti-bacterials. They ideally need to be refrigerated if this is recommended by the manufacturer but not all those mentioned require this. If histamine issues are a problem, then certain probiotics can inhibit or release histamine.

Please discuss with a practitioner or do further research before deciding on an appropriate probiotic. It is recommended to contact the manufacturer to discuss personal queries further before purchasing. The following have been noted to help those particularly with bladder issues

VSL3 or Vivomax It needs to be refrigerated.

Fem-Dophilus by Jarrow. The purchase company should deliver on ice and keep refridgerated.

Ther-biotic Factor 1 by Klaire labs. This is suitable for very sensitive bladders. Keep refrigerated.

Ultimate Flora Women’s Probiotic It does not need to be refridgerated.

Optibac Probiotics which include products for those taking antibiotics and also one for vaginal health. It does not need to be refridgerated

Biokult Probiotics These do not need to be refridgerated.

Syntol AMD by Arthur Andrew Medical. It does not need to be refrigerated.

Symprove is a water-based multi-strain supplement that contains 4 unique strains of live activated bacteria. It does not need to be refrigerated.

S. boulardii is a unique, non-pathogenic yeast supplement that can be used as a probiotic to support gastrointestinal health. S. boulardii is completely unrelated to Candida albicans, C. tropicalas, C. krusie and other Candida species that cause disease and overgrowth in the gastrointestinal and genitourinary tracts. It does not need to be refrigerated.

Hello blue sngel,i sm burny and dsore... a.nd find sitting and walking about miserable , i just thought that it is coming from my inflsmed bladder do you think this may be where yours is from.__________________H.M Whitworth

Hi we all seem to get such different symptoms with this bladder condition .i hsve just been to wee and now have burning vulval and anus pain,just want to go out for a walk, couldn't possibly like this,just feel like an invalid, so deptessing.Hope you find some relief for your soreness .Heather.__________________H.M Whitworth

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